Skip Navigation

Request Information

Thank you for your interest in Regina Angelorum Academy!

Please fill out the form below, and we will contact you shortly to provide additional information regarding your request.


Sincerely,

Mrs. Ann Coffey

Principal

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • How Did You Hear About Us?
    Details:

  • Religious Affiliation:
    *

  • Are you interested in a tour?
    Yes   No
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •